title: The relationship of patient participation and diabetes outcomes for patients with high vs. low health literacy.
abstract: OBJECTIVE
  To examine whether patient participation in medical consultations have differing effects on self-efficacy and diabetes control by the level of patient communicative health literacy (CHL).
  
  
  METHODS
  Participants were 143 outpatients with type 2 diabetes at a university-affiliated hospital. Patient CHL was measured using a newly developed self-rated scale of health literacy. Patient perceived participation in medical consultations and self-efficacy of diabetes self-care were assessed using the self-reported questionnaire. Patient clinical characteristics were obtained from electronic medical records.
  
  
  RESULTS
  Both patient CHL and perceived participation were related to greater self-efficacy and decreased HbA1c at the 3-month follow-up. Patient CHL had a moderating effect on the relationship between perceived participation and self-efficacy. Patients with lower CHL reported greater self-efficacy when they actively participated in patient-physician communication, whereas this relationship was less evident among patients with higher CHL.
  
  
  CONCLUSIONS
  The examination of patient CHL levels may provide a better understanding of the potential barriers to patients' self-management of disease.
  
  
  CONCLUSIONS
  The benefit of active participation may be greater among patients with lower CHL who are likely to have greater difficulties in communicating with the physician, yet tend to rely on the physician as the sole source of health information.
authors.affiliation: Department of Health Communication, School of Public Health, The University of Tokyo, Japan. hirono-tky@umin.ac.jp
authors.forename: Hirono
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Eiji
authors.initials: E
authors.lastname: Yano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin; D057220:Health Literacy; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D010817:Physician-Patient Relations; D012111:Residence Characteristics; D020377:Self Efficacy; D057566:Self Report; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin